Organization Name: | WYOMING CREATIVE COUNSELING OPTIONS, INC. |
NPI Number: | 1033306097 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAMMY D BROWN (PRESIDENT) |
Mailing Address: | 204 5th St Rawlins |
State: | WY US |
Postal Code: | 823015633 |
Phone Number: | 3073211426 |
Fax Number: | 3073245073 |
NPI Enumeration Date: | 10/03/2007 |
NPI Last Update Date: | 10/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 446 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |